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  • 1
    Electronic Resource
    Electronic Resource
    Human leucocyte antigen determinants of susceptibility to Barrett's oesophagus in Asians – a preliminary study (2005)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 21 (2005), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Characteristic immune profiles have been demonstrated in gastro-oesophageal reflux disease. However, the genetic basis of gastro-oesophageal reflux disease remains unclear.Aim : To investigate whether certain human leucocyte antigen genes are associated with Barrett's oesophagus.Methods : Asian patients of Malay, Chinese and Indian descent with Barrett's oesophagus (n = 59) and those without reflux symptoms and a normal oesophagus (n =60) were recruited prospectively using endoscopic and histopathological criteria. Human leucocyte antigen class I and II typing was performed using a polymerase chain reaction sequence-specific primers method.Results : The HLA-B7 allele was present in 17% (10 of 59) of patients with Barrett's oesophagus when compared with 0% (zero of 60) of controls [P = 0.0006, corrected P = 0.0171, OR = 25.67]. Subgroup analysis revealed that the HLA-B7 allele was confined almost exclusively to Indians with Barrett's oesophagus, 43% (nine of 21) vs. 0% (zero of 19) Indian controls (P = 0.0014, corrected P = 0.0406, OR = 29.64). No class II associations, protective human leucocyte antigens or extended haplotypes for disease susceptibility were identified.Conclusions : Barrett's oesophagus in Asians, particularly Indians, is strongly positively associated with HLA-B7; reinforcing a genetic component to gastro-oesophageal reflux disease. A larger sample size and different ethnic populations should be genotyped to further confirm this association and identify possible additional risk factors in the human leucocyte antigen locus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2005.02496.x
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  • 2
    Electronic Resource
    Electronic Resource
    Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy (2005)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 22 (2005), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Colorectal cancer is one of the most common forms of gastrointestinal cancer in the world today. In the Asia–Pacific area, it is the fastest emerging gastrointestinal cancer.Aim : To determine the basic demographic features of patients with colorectal cancer and the anatomic distribution and characteristics of the tumour in a local Asian population.Methods : We conducted a review of consecutive patients who had undergone colonoscopy from 1999 to 2003 at the University of Malaya Medical Center, Kuala Lumpur, Malaysia.Results : Analysis was carried out on 3404 patients who underwent colonoscopy. A total of 228 patients (7%) were diagnosed with carcinoma. The mean age of diagnosis (±s.d.) was 64.4 ± 13.1 years. The male to female ratio was 1.15. Polyps were noted in 470 patients (14%). Polyps detected concomitantly with a colorectal cancer were noted in 55 patients (2%). Four patients (0.1%) were diagnosed to have familial adenomatous polyposis coli. Of the 228 patients 209 (92%) had tumours at only one site whereas 19 (8%) had synchronous lesions. Tumours were mainly left sided [198 of 248 patients (80%)] with the majority located in the recto-sigmoid region. Detailed records of treatment were available only in 176 patients. A total of 147 of 176 patients (84%) underwent surgery and 50 (28%) also received adjuvant or palliative chemotherapy (28%). Seven of 154 patients (5%) were diagnosed to have stage A cancers, 64 (42%), stage B, 23 (15%), stage C and 60 (39%), stage D. Multivariate analysis using multiple logistic regression analysis showed that age ≥65 years (OR = 1.78; 95% CI: 1.35– 2.36) and Malay (OR = 2.09; 95% CI: 1.30–3.35) and Chinese (OR = 1.77; 95% CI: 1.77–2.69) race were significant independent predictive factors for colorectal cancer.Conclusions : The demography of colorectal cancer is different from western patients. Tumours were mainly left sided in our patients. However, no differences in anatomic location were found between races, men and women and younger and older age groups. Colorectal cancer presented in an advanced stage in the majority of patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2005.02646.x
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  • 3
    Electronic Resource
    Electronic Resource
    Gastro-oesophageal reflux is more prevalent in Western dyspeptics: a prospective comparison of British and South-East Asian patients with dyspepsia (2005)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 21 (2005), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : There is a paucity of data directly comparing dyspepsia in Western and Eastern populations.Aim : To compare clinical symptoms, epidemiological factors and endoscopic diagnoses in two sample populations with dyspepsia from the United Kingdom and South-East Asia in a cross-sectional study.Methods : Patients with uncomplicated dyspepsia attending endoscopy units in Leeds, UK, and Kuala Lumpur, Malaysia, were prospectively interviewed and underwent subsequent endoscopy.Results : A total of 1003 Malaysian patients (January 2002 to August 2003) and 597 Caucasian British patients (January 2000 to October 2002) were studied. The mean age was 48.7 ± 15.8 and 47.5 ± 13.8 years for the Malaysian and British patients respectively (P = NS). There was a higher proportion of cigarette smoking (35.7% vs. 12.4%, P 〈 0.0001) and alcohol consumption (34.4% vs. 2.0%, P 〈 0.0001) amongst British patients, but no difference in non-steroidal anti-inflammatory drug use nor having Helicobacter pylori infection. Gastro-oesophageal reflux disease (GERD) symptoms were more common in British compared with South-East Asian patients [heartburn (72% vs. 41%), regurgitation (66% vs. 29.8%) and dysphagia (21.1% vs. 7.3%), P 〈 0.0001]. This correlated with an increased endoscopic finding of oesophagitis (26.8% vs. 5.8%) and columnar-lined oesophagus (4.4% vs. 0.9%) amongst British patients (P 〈 0.001). A logistic regression model revealed that British Caucasian race (OR 9.7; 95% CI = 5.0–18.8), male gender (OR 2.0; 95% CI = 1.4–2.9) and not having H. pylori infection (OR 0.5; 95% CI = 0.3–0.7) were independent predictors for oesophagitis.Conclusion : GERD is more common in British compared with South-East Asian dyspeptic patients suggesting that race and/or western lifestyle are important risk factors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2005.02455.x
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  • 4
    Electronic Resource
    Electronic Resource
    Comparison of two 1-week low-dose omeprazole triple therapies— optimal treatment for Helicobacter pylori infection? (1997)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 11 (1997), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: To determine and compare the efficacy and tolerability of two 1-week regimen comprising omeprazole, clarithromycin and amoxycillin or metronidazole in the eradication of Helicobacter pylori, and to determine the influence of bacterial resistance to metronidazole and clarithromycin on the outcome of treatment.〈section xml:id="abs1-2"〉〈title type="main"〉Patients and methods:Patients with unequivocal evidence of H. pylori infection based on culture, histology and rapid urease test of both antrum and corpus biopsies were recruited for the study. The study was a randomized, investigator-blind, comparative study. Patients received either omeprazole 20 mg o.m., clarithromycin 250 mg b.d. and amoxycillin 500 mg b.d. (OAC) or omeprazole 20 mg o.m., metronidazole 400 mg b.d. and clarithromycin 250 mg b.d. (OMC) for 1 week. Patients were assessed for successful eradication, which was defined as absence of bacteria in all tests (culture, histology and urease test on both antral and corpus biopsies), at least 4 weeks after completion of therapy.〈section xml:id="abs1-3"〉〈title type="main"〉Results:Eighty-two patients were recruited for the study. Eradication rates on intention-to-treat analysis were—OAC: 36/41 (87.8%, 95% CI: 73.8, 95.9); OMC: 33/41 (80.5%, 95% CI: 65.1, 91.2). On per protocol analysis were—OAC: 36/40 (90%, 95% CI: 76.3, 97.2); OMC: 32/38 (84.2%, 95% CI: 68.7, 94.0). All side-effects encountered were mild and no patient discontinued treatment because of intolerance to medications. The most common side-effects were altered taste (OAC 31.7%, OMC 53.7%) and lethargy (OAC 14.6%, OMC 19.5%). Pre-treatment metronidazole resistance was encountered in 34/63 (54.0%) patients. No bacterial strains were found with primary resistance to clarithromycin. Metronidazole resistance did not significantly affect eradication rates. Emergence of resistance to clarithromycin was not seen post-therapy.〈section xml:id="abs1-4"〉〈title type="main"〉Conclusions:Both the OAC and the OMC regimens were convenient and well-tolerated treatments for H. pylori. However, eradication rates were lower than anticipated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.1997.00248.x
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  • 5
    Electronic Resource
    Electronic Resource
    Finite element analysis of the effect of fibre shape on stresses in an elastic fibre surrounded by a plastic matrix (2000)
    Springer
    Journal of materials science 35 (2000), S. 2493-2497 
    Details
    ISSN: 1573-4803
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics
    Notes: Abstract The finite element (FE) method was used to calculate the axial and radial stress distributions as a function of axial distance, z, from the centre, and radius, r, in an elastic fibre surrounded by a plastic matrix. Plastic deformation of the matrix was considered to exert a uniform interfacial stress, τ, along half the length of the fibre. Axisymmetric models were created for uniform cylindrical, ellipsoidal, paraboloidal and conical fibres characterised by an axial ratio, q, and half length, L. Young's modulus for the material of the fibre and L were arbitrarily assigned values of unity, since they act as scaling factors; q also acts as a scaling factor but was assigned a value of 10 to create models with a fibrous appearance. For the cylindrical fibre, the axial stress increased linearly from the end towards the centre; the radial stress was more evenly distributed. At the other extreme, the conical fibre showed a uniform distribution of axial and radial stress. Results for ellipsoidal and paraboloidal fibres were intermediate between these two extremes. In general, the effect of taper is to lower peak stress at the fibre centre and make the stress distribution throughout the fibre more even. These results are in good agreement with recent analytical theories for the axial distribution of surface radial stress and axial stress along the fibre axis. However, FE models have the advantage of predicting full three-dimensional stress distributions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1004725903966
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